Psychiatric symptoms delay the diagnosis of anti-LGI1 encephalitis

Yoonhyuk Jang; Soon-Tae Lee; Jung-Ah Lim; Tae-Joon Kim; Jin-Sun Jun; Jangsup Moon; Jun-Sang Sunwoo; Keun-Hwa Jung; Kyung-Il Park; Ki-Young Jung; Manho Kim; Sang Kun Lee; Kon Chu

doi:10.1016/j.jneuroim.2018.02.005

Psychiatric symptoms delay the diagnosis of anti-LGI1 encephalitis

J Neuroimmunol. 2018 Apr 15:317:8-14. doi: 10.1016/j.jneuroim.2018.02.005. Epub 2018 Feb 7.

Authors

Affiliations

¹ Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea.
² Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, National Center for Mental Health, an Affiliate of the Ministry for Health and Welfare, Seoul, South Korea.
³ Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, South Korea.
⁴ Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea; Department of Neurology, Seoul National University Healthcare System Gangnam Center, Seoul, South Korea.
⁵ Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: sangkun2923@gmail.com.
⁶ Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: stemcell.snu@gmail.com.

PMID: 29501086
DOI: 10.1016/j.jneuroim.2018.02.005

Abstract

The aim of this study was to analyze the detailed characteristics of the psychiatric symptoms in patients with anti-LGI1 encephalitis. Of 16 patients, ten showed psychiatric symptoms as the initial manifestations. All 10 patients experienced mood-related symptoms. The time to immune therapy was longer in those with initial psychiatric symptoms compared to those without them. Initial manifestation of psychiatric symptoms in patients with anti-LGI1 encephalitis may be a poor prognostic factor, at least in the short term, in that it misleads both the patients and the clinicians to neglect the typically accompanied symptoms of the disease such as faciobrachial dystonic seizure, delaying the timing of immune therapy.

Keywords: Anti-LGI1 encephalitis; Dementia; Epilepsy-related psychosis; Prognostic factor; Psychiatric symptom; Senile depression.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Autoimmune Diseases / diagnosis*
Autoimmune Diseases / immunology
Autoimmune Diseases / psychology*
Cohort Studies
Delayed Diagnosis
Encephalitis / diagnosis*
Encephalitis / immunology
Encephalitis / psychology*
Female
Humans
Intracellular Signaling Peptides and Proteins
Male
Mental Disorders / etiology*
Middle Aged
Prospective Studies
Proteins / immunology*
Time-to-Treatment

Substances

Intracellular Signaling Peptides and Proteins
LGI1 protein, human
Proteins